前列腺素E联合连续肾替代治疗对脓毒症合并急性肾损伤预后的影响

目的:探讨前列腺素E联合连续肾替代治疗(CRRT)对脓毒症合并急性肾损伤(AKI)患者预后的影响。方法:选取89例脓毒症合并AKI患者为研究对象,采用随机数字表法分为对照组(n=44)和观察组(n=45),分别采取CRRT及前列腺素E联合CRRT治疗。比较2组患者预后转归情况,检测并比较2组患者治疗前后血清炎性因子、肾功能及免疫功能指标。结果:观察组ICU治疗时间及住院时间较对照组明显缩短(P<0.05);对照组死亡14例(31.82%),观察组死亡9例(20.00%),2组患者死亡率无明显差异(P>0.05)。与治疗前比较,治疗后2组血清TNF-α、IL-6、hs-CRP含量降低,BUN、SCr含量升高(P<0.05),且观察组上述指标均低于对照组(P<0.05)。与治疗前比较,治疗后2组CD4^+/CD8^+及观察组NK细胞比例及IgG、IgA、IgM含量均明显升高(P<0.05),且观察组高于对照组(P<0.05)。与治疗前比较,治疗后2组Marshall评分、APACHEⅡ评分下降(P<0.05),且观察组低于对照组(P<0.05)。结论:前列腺素E联合CRRT治疗脓毒症合并AKI可显著降低患者炎性因子水平,改善患者肾功能和免疫功能,效果优于单独CRRT治疗。

Effect of prostaglandin E combined with continuous renal replacement therapy Xuebijing on prognosis in septic patients with acute kidney injury

OBJECTIVE To investigate the effect of prostaglandin E combined with continuous renal replacement therapy (CRRT) combined with Xuebijing on prognosis in patients with sepsis with acute kidney injury (AKI). METHODS 89 cases of sepsis with AKI patients were selected as the research subjects, the patients were divided into the control group (n=44) and the observation group (n=45) according to the random digital table method, both of which were treated with CRRT and prostaglandin E combined with CRRT respectively. The prognosis of the 2 groups were compared. Serum inflammatory factors, renal function and immune function indexswere detected and compared between the 2 groups before and after treatment. RESULTS The ICU treatment time and hospitalization time in the observation group were significantly shorter than those in the control group (P<0.05). 14 cases (31.82%) of death were in the control group, and 9 cases (20.00%) of death were in the observation group, and there was no significant difference in the mortality rate between the 2 groups (P>0.05). Compared with those before treatment, the contents of TNF-α, IL-6 and hs-CRP in serum decreased, while the contents of BUN and SCr increased in the two groups after treatment (P<0.05), and the above indicators in the observation group were lower than those in the control group (P<0.05). Compared with those before treatment, the CD4⁺/CD8⁺ in the 2 groups and the NK cells proportion, the content of IgG, IgA and IgM in the observation group increased significantly (P<0.05), and were higher in the observation group than in the control group (P<0.05). Compared with those before treatment, the Marshall scores and APACHE Ⅱ scores of the 2 groups decreased after treatment (P<0.05), and were lower in the observation group than in the control group (P<0.05). CONCLUSION Prostaglandin E combined with CRRT in the treatment of sepsis with AKI can significantly reduce the level of inflammatory factors and improve renal function as well as immune function, and the effect is better than that of CRRT alone.